{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"TRACEY   L CALLIS","gend":0,"add":"7401 WARWICK BLVD","city":"NEWPORT NEWS","state":"VA","zip":"23607-9998","dob":"1975-04-04","age":"","mstatus":"","insh":"2321917*01","cliId":"","pno":"757\/509-0949","cno":"757\/509-0949","email":"","ename":"","eno":"","pphy":"MCGAVERN, MEGAN B DO","ppno":"757\/234-4285","pcpadd":"12652 JEFFERSON AVE","pcpcity":"NEWPORT NEWS","pcpstate":"VA","pcpzip":23602,"pcpcounty":"","pcpid":"","pcpname":"Riverside Internal Medicine of Denbigh","plan":"OHP","program":"MEDICAID","lob":"M4","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"757\/234-4260","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.2","R07.89","Z02.2","M25.561","M25.562","F31.9","V62.84","Z59.0","Z20.822","F29.","F41.1","J20.9","Z72.0","S50.02XA","K08.9","G89.29","H10.45","H52.03","H52.223","H52.4","T14.90XA","M54.5","J45.909","Z87.440","F17.200","Z79.899","R10.9","D72.829","F17.210","Z87.442","F31.2","J45.901","Z86.73","R06.02","Z03.818","S39.012A","NO DATA","Z71.6","R06.2"],"date":["2022-05-15","2022-08-20","2020-12-01","2020-12-01","2020-12-01","2020-12-01","2021-01-28","2021-01-28","2022-07-26","2021-01-28","2021-07-14","2022-07-26","2022-07-26","2020-11-12","2020-11-12","2020-11-12","2021-09-09","2021-09-09","2021-09-09","2021-09-09","2020-11-12","2021-09-04","2022-07-26","2022-07-26","2021-10-26","2021-09-04","2021-09-04","2022-05-17","2022-07-26","2022-07-26","2021-07-27","2022-07-22","2022-07-22","2022-07-22","2020-11-30","2021-10-26","2021-10-26","2022-07-26","2022-07-26"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","60505082901","FLUTICASONE","SPR 50MCG","16","Select","Select",""],["","42806031250","DOXYCYCL","TAB 100MG","14","Select","Select",""],["","42806071401","BENZONATATE","CAP 100MG","15","Select","Select",""],["","43598081115","CETIRIZINE","TAB 10MG","30","Select","Select",""],["","11822312760","LORATADINE","TAB 10MG","30","Select","Select",""],["","00172572860","FAMOTIDINE","TAB 20MG","10","Select","Select",""],["","66993001968","ALBUTEROL","AER HFA","18","Select","Select",""],["","42806040021","METHYLPRED","TAB 4MG","21","Select","Select",""],["","43547028110","ESCITALOPRAM","TAB 10MG","14","Select","Select",""],["","67877043003","ARIPIPRAZOLE","TAB 2MG","30","Select","Select",""],["","65162018810","NAPROXEN","TAB 250MG","14","Select","Select",""],["","70010075401","METHOCARBAM","TAB 500MG","15","Select","Select",""],["","00093310953","AMOXICILLIN","CAP 500MG","21","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}